Michelle Bollom, OTD, OTR/L, CTRS-C

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTH-009789 Issued in AZ

Practice address

712 Brown Ave
Erie, PA 16502-2532

Phone

(602) 884-0584

NPI assigned

Oct 17, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1699103291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 BROWN AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022532",
            "telephone_number": "602-884-0584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 BROWN AVE",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165022532",
            "telephone_number": "602-884-0584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLOM",
        "first_name": "MICHELLE",
        "credential": "OTD, OTR/L, CTRS-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-17",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryant E Bojewski, DO
• Roman E Bojewski, DO
• Lizette Bolden
• Aneel Kumar Bole, M.D.
• Glenn Alden Bollard, MD
• Christopher Michael Bolton
• Vanessa Bonatto, LCSW
• Erica Lyn Boncella, LPC
• Mbembo Bongutu, MD
• Megan Gwendolyn Bonk

• All providers in Erie, PA
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.